CONTRACTS PRIVILEGED COMMUNICATION PRIVACY ACT LEGAL AND ETHICAL CONTRACTS PRIVILEGED COMMUNICATION PRIVACY ACT

Contracts An agreement between two or more parties Most contracts have 3 parts: Offer: a competent individual enters into a relationship with a health care provider and offers to be a new patient Acceptance: the health care provider gives an appointment or examines or treats the patient Consideration: the payment made by the patient for services provided

Contracts Implied: those obligations that are understood without verbally expressed terms. Example, when a qualified health worker prepares a medication and a patient takes a medication, it is implied that the patient accepts this treatment Expressed: stated in distinct and clear language, either orally or in writing. Example, a surgery permit. Promises of care must be kept. Therefore, all risks associated with treatment must be explained completely by the patient

Legal Disability All parties entering into a contract must be free of it Person does not have the legal capacity to form a contract Examples are minors, mentally incompetent persons, individuals under the influence of drugs that alter the mental state, and semiconscious or unconscious people. Parents, guardians, or others permitted by law must form the contract for the individual

Breach of Contract If a contract is not performed according to the agreement, the contract is breached Failure to provide care and giving improper care are breaches of contract If the patient refuses to pay for care, this can be considered breach of contract and lead to legal action

Translator Law required that a translator must be used when a contract is explained to a non-English speaking person Many states require the use of translator services for those that are deaf or hard of hearing At times, an English-speaking relative or friend of the patient can also serve as a translator

Agent When a person works under the direction of another person, the employer is called the principal and the employee is called the agent. The principal is responsible for the actions of the agent He or she can be required to pay or otherwise compensate people who have been injured by the agent Health care workers must be aware of their role as agents and work to protect the interests of their employees

Privileged Communications Include all information given to health care personnel by a patient By law, this information must be kept confidential and shared only with other members of the patient’s health care team It cannot be told to anyone else without the WRITTEN consent of the patient

Consent The written consent must state: What information is to be released To whom the information should be given Any time limits Certain information is exempt by law and must be reported. Here are some examples: Births and deaths Injuries caused by violence (assault and battery, abuse, stabbings) that may require police involvement Drug abuse Communicable diseases STDs

Health Care Records Also privileged communications The record belongs to the health care provider, but the patient has the right to obtain a copy of any info in the record Can be used as legal records in a court of law For this reason the following principles must be followed…..

Health Care records continued… Erasures are NOT allowed Errors should be crossed out with a single line so material is still readable Correct information should then be inserted, initialed, and dated If necessary, an explanation for the correction should also be provided

More Principles to Follow Health care records must be properly maintained, stored in a locked or secure area, kept confidential, and retained for the amount of time required by stated law If records are destroyed after the legal time for retention, they should be burned or shredded to maintain confidentiality

Computerized Records The growing use of computerized records has created a dilemma in maintaining confidentiality Many health care providers are creating safeguards to maintain confidentiality, such as: Limiting personnel who access to such records Using codes to prevent access to certain info Requiring passwords in order to access specific information on records Constantly monitoring and evaluating computer use

Privacy Act The Health Insurance Portability and Accountability Act (HIPAA) Created by Congress in 1996 Required the U.S. Department of Health and Human Services (USDHHS) to establish standards to protect health info USDHHS published the Standards for Privacy of Individually Identifiable Health Information (aka Privacy Rule) Went into effect in 2003

Privacy Rule Standards provide federal protection for privacy of health information in all states Patients must be: Able to see and obtain copies of their medical records Given information by health care providers about how they use medical information Allowed to set limits on how personal health information is used Permitted to request that health care providers take reasonable care to keep communications confidential Given the right to state who has access to their information and even to limit providing information to their family Provided with information on how to file a complaint against a health care provider who violates the privacy act

“Last Thought” Most health care agencies have specific rules, regulations, and standards that determine activities performed by individuals holding different positions of employment IT IS YOUR RESPONSIBILITY TO LEARN EXACTLY WHAT YOU ARE LEGALLY PERMITTED TO DO AND TO FAMILIARIZE YOURSELF WITH YOUR EXACT RESPONSIBILITIES